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Ferreira NV, Bertola L, Santos IS, Goulart AC, Bittencourt MS, Barreto SM, Giatti L, Caramelli P, Pereira A, Lotufo PA, Bensenor IM, Suemoto CK. Association between carotid intima-media thickness and cognitive decline differs by race. Alzheimers Dement 2023; 19:3528-3536. [PMID: 36825689 DOI: 10.1002/alz.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Common carotid intima-media thickness (cIMT) is a marker of subclinical atherosclerosis and is associated with cognitive decline. Although carotid atherosclerosis is more frequent in White than in Black participants, little is known whether race modifies the association between cIMT and cognitive decline. METHODS In this longitudinal analysis of the ELSA-Brasil, we assessed cIMT using ultrasound and cognitive performance using different domain tests. We used linear mixed models, interaction analysis, and race stratified analyses. RESULTS Baseline high IMT values were associated with memory (p < 0.001), verbal fluency (p < 0.001), TMT-B (p < 0.001)), and global cognitive decline (p < 0.001). Race was an effect modifier in the association between IMT and global cognitive decline (0.043), with stronger association in White (p < 0.001) than in Black (p = 0.009) participants. DISCUSSION Baseline IMT was associated with global and domain-specific cognitive decline and race modified this relationship, with stronger associations in White participants. HIGHLIGHTS Carotid intima-media thickness (cIMT) was associated with cognitive decline. cIMT and cognitive decline association was stronger in White than in Black participants. We used inverse probability weighting to address attrition bias.
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Affiliation(s)
- Naomi Vidal Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Adventist University of Sao Paulo, Engenheiro Coelho, Sao Paulo, Brazil
- Amazonia Adventist College, Benevides, Pará, Brazil
| | - Laiss Bertola
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marcio S Bittencourt
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sandhi Maria Barreto
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- School of Medicine and Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Pereira
- Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Sao Paulo, Brazil
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Zhu X, Jing R, Li X, Zhang W, Tang Y, Liu T. Left ventricular hypertrophy, carotid atherosclerosis, and cognitive impairment in peritoneal dialysis patients. BMC Cardiovasc Disord 2023; 23:127. [PMID: 36890445 PMCID: PMC9996916 DOI: 10.1186/s12872-023-03130-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/19/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) and carotid atherosclerosis (CAS) have been identified as factors associated with cognitive impairment (CI) but have not been studied in patients undergoing peritoneal dialysis (PD). This study investigated the relationship between LVH and CAS and cognitive function in patients undergoing PD. METHODS In this single-center cross-sectional study, the clinically stable patients who were over 18 years of age and had undergone PD for at least 3 months were enrolled. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), which included seven areas: visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation. LVH was defined as LVMI > 46.7 g/m2.7 in women and LVMI > 49.2 g/m2.7 in men. CAS was defined as carotid intima-media thickness ≥ 1.0 mm and/or the presence of plaque. RESULTS A total of 207 patients undergoing PD were recruited, with an average age of 52.14 ± 14.93 years and a median PD duration of 8 months (5-19 months). The CI rate was 56%, and the prevalence of CAS was 53.6%. LVH occurred in 110 patients (53.1%). Patients in the LVH group tended to be older, and had a higher body mass index, a higher pulse pressure, a higher male proportion, a lower ejection fraction, a higher prevalence of cardiovascular disease and CI, and a lower MoCA scores.Multivariate logistic regression analysis was conducted to analyze the association between LVH and CI (OR, 10.087; 95% confidence interval, 2.966-34.307). And the association between LVH and CI was still supported after propensity matching scores. CAS was not significantly associated with CI. CONCLUSION LVH is independently associated with CI in patients undergoing PD, while CAS is not significantly associated with CI.
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Affiliation(s)
- Xuejing Zhu
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China
| | - Ran Jing
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China
| | - XiaoPing Li
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China
| | - Wanfen Zhang
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China
| | - Yushang Tang
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China
| | - Tongqiang Liu
- Department of Nephrology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, 68# Middle Gehu Road, Changzhou, 213164, Jiangsu Province, People's Republic of China.
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De Anda-Duran I, Alonso CF, Libon DJ, Carmichael OT, Kolachalama VB, Suglia SF, Au R, Bazzano LA. Carotid Intima-media Thickness and Midlife Cognitive Function: Impact of Race and Social Disparities in the Bogalusa Heart Study. Neurology 2022; 98:e1828-e1836. [PMID: 35228334 PMCID: PMC9109147 DOI: 10.1212/wnl.0000000000200155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Carotid intima-media thickness (c-IMT) is a measurement of atherosclerosis, a progressive disease that develops as early as childhood and has been linked with cognitive impairment and dementia in the elderly. However, the relationship between c-IMT and midlife cognitive function as well as race and social disparities on this relationship remains unclear. We examined the association between c-IMT and cognitive function in midlife among Black and White participants from a semi-rural community-based cohort in Bogalusa, Louisiana. METHODS In this cross-sectional analysis of participants from the Bogalusa Heart Study, linear regression models were used to determine the association between c-IMT dichotomized above the 50th percentile (> 0.87mm), an a demographically standardized global cognitive (GCS) and individual cognitive domain-based z-scores. Stratified analyses were performed to evaluate the impact of race and the individual's education status. RESULTS A total of 1,217 participants (age 48 ± 5.28 years) were included, 66% (804) self-identified as White and 34% (413) as Black. Of those, 58% (708) were women, and 42% (509) were men Having a c-IMT > 50th percentile was inversely associated with GCS ([B ± SE]: -0.39 ± 0.18, P=0.03), independent of cardiovascular risk factors (CVRFs) and achieved education. The effect remained significant in Black and White participants after adjustment for CVRFs (Blacks: [B ± SE]: -1.25 ± 0.45, P=0.005; Whites: [B ± SE]: -0.92 ± 0.35, P=0.008), but not for education. The interaction between c-IMT >50th percentile and education was significant (P=0.03), and stratified analysis showed an association with GCS among those with lower achieved education ([B ± SE]: -0.81 ± 0.33, P=0.013) independent of major CVRFs. DISCUSSION Subclinical atherosclerosis, measured as c-IMT, was associated with worse midlife cognitive function, independent of major CVRFs. The association was buffered by education and may be stronger among Black than White participants, likely due to corresponding structural and social determinants. These findings underscore the importance of establishing preventive measures in midlife and suggest subclinical atherosclerosis as a potential target to prevent cognitive decline.
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Affiliation(s)
- Ileana De Anda-Duran
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - David J Libon
- Department of Psychology, Rowan University, Glassboro, NJ, USA.,New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Glassboro, NJ, USA
| | - Owen T Carmichael
- Louisiana State University's Pennington Biomedical Research Centre, Baton Rouge, LA, USA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Computer Science and Faculty of Computing and Data Sciences , Boston University, Boston, MA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA, and Boston University Alzheimer's Disease Center, Boston, MA, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.,Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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Álvarez-Bueno C, Cavero-Redondo I, Bruno RM, Saz-Lara A, Sequí-Dominguez I, Notario-Pacheco B, Martinez-Vizcaino V. Intima Media Thickness and Cognitive Function Among Adults: Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2022; 11:e021760. [PMID: 35179392 PMCID: PMC9075078 DOI: 10.1161/jaha.121.021760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.
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Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Universidad Politécnica y Artística del Paraguay Asunción Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Rehabilitation in Health Research Center (CIRES)Universidad de las Americas Santiago Chile
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa Italy.,INSERM U970 and Université de Paris Paris France
| | - Alicia Saz-Lara
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain
| | | | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
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5
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Liu H, Yang S, He W, Liu X, Sun S, Wang S, Wang Y, Zhou X, Tang T, Xia J, Liu Y, Huang Q. Associations Among Diffusion Tensor Image Along the Perivascular Space (DTI-ALPS), Enlarged Perivascular Space (ePVS), and Cognitive Functions in Asymptomatic Patients With Carotid Plaque. Front Neurol 2022; 12:789918. [PMID: 35082748 PMCID: PMC8785797 DOI: 10.3389/fneur.2021.789918] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022] Open
Abstract
Background and Aim: Carotid atherosclerosis (CAS) is a common pathogenesis of cerebrovascular disease closely related to stroke and silent cerebrovascular disease (SCD), while the insufficient brain perfusion mechanism cannot quite explain the mechanism. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate the glymphatic system activity and correlated DTI-ALPS with enlarged perivascular spaces (ePVS), carotid intima-media thickening (CIMT), mini-mental state examination (MMSE), and serological indicator in individuals with carotid plaque. Methods: Routine MRI and diffusion tensor images scan of the brain, carotid ultrasound, and blood examination were conducted on 74 individuals (52 carotid plaque subjects, 22 non-carotid plaque subjects), whose demographic and clinical characteristics were also recorded. DTI-ALPS index between patients with carotid plaque and normal controls were acquired and the correlations with other variables were analyzed. Results: The values of ALPS-index in the carotid plaque group was significantly lower compared to normal controls (2.12 ± 0.39, 1.95 ± 0.28, respectively, p = 0.034). The ALPS-index was negatively correlated with the basal ganglia (BG)-ePVS score (r = -0.242, p = 0.038) while there was no significant difference in the centrum semiovale (CSO)-ePVS score. Further analysis showed that there are more high-grade ePVS in the BG compared to the carotid plaque group than in the non-carotid plaque group (84.6% vs. 40.9%, p = 0.001). Conclusions: ALPS-index reflects the glymphatic system of the brain, which is associated with early high-risk cerebrovascular diseases. There may be damage in the function of the glymphatic system which induces the expansion of the perivascular space (PVS) in the BG in individuals with carotid plaque.
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Affiliation(s)
- Hui Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Shuai Yang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Wei He
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojuan Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Shanyi Sun
- Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Song Wang
- Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Wang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoliang Zhou
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Tang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Xia
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yunhai Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qing Huang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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6
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Mohseni-Moghaddam P, Ghobadian R, Khaleghzadeh-Ahangar H. Dementia in Diabetes mellitus and Atherosclerosis; Two Interrelated Systemic Diseases. Brain Res Bull 2022; 181:87-96. [DOI: 10.1016/j.brainresbull.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/18/2021] [Accepted: 01/24/2022] [Indexed: 12/06/2022]
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7
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Baradaran H, Sarrami AH, Gupta A. Asymptomatic Carotid Disease and Cognitive Impairment: What Is the Evidence? Front Neurol 2021; 12:741500. [PMID: 34867724 PMCID: PMC8636319 DOI: 10.3389/fneur.2021.741500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/25/2021] [Indexed: 11/23/2022] Open
Abstract
The development of cognitive dysfunction and dementia is a complex, multifactorial process. One of the contributors to various types of cognitive dysfunction is carotid atherosclerosis which can frequently be seen in asymptomatic individuals. There are a number of different manifestations of asymptomatic carotid atherosclerosis including arterial stiffness, carotid intima-media thickening, flow-limiting stenosis, and complex, atherosclerotic plaque. Each of these forms of atherosclerosis may contribute to cerebral parenchymal damage, contributing to cognitive dysfunction. In this review article, we will discuss each of these forms of carotid atherosclerosis, present the potential mechanistic underpinnings behind an association, and then review the scientific evidence supporting potential associations to cognitive dysfunction and dementia.
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Affiliation(s)
- Hediyeh Baradaran
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States
| | - Amir Hossein Sarrami
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States
| | - Ajay Gupta
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States.,Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
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8
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Effect of age stratification on the association between carotid intima-media thickness and cognitive impairment in Chinese hypertensive patients: new insight from the secondary analysis of the China Stroke Primary Prevention Trial (CSPPT). Hypertens Res 2021; 44:1505-1514. [PMID: 34493836 DOI: 10.1038/s41440-021-00743-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
The current study aimed to explore the association between carotid intima-media thickness (CIMT) and cognitive function assessed by the Mini-Mental State Examination (MMSE) and to examine possible effect modifiers in hypertensive patients. A total of 14,322 hypertensive participants (mean age 64.2 ± 7.4 years; 40.9% male) from the China Stroke Primary Prevention Trial (CSPPT) were included in the final analysis. CIMT was measured by ultrasound, and data were collected at the last follow-up visit; MMSE was used to evaluate cognitive function. Nonparametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the relationship between the CIMI and cognitive function and effect modification. The mean CIMT was 0.74 ± 0.11 mm, and the mean MMSE score was 23.5 ± 4.8. There was a significant interaction (P interaction < 0.05) in both male and female populations stratified by age (<60 vs. ≥60 years), and higher CIMT was significantly associated with decreased MMSE scores only in participants aged ≥60 years (male: β = -2.29, 95% CI -3.23 to -1.36; female: β = -1.96, 95% CI -2.97 to -0.95). Males with abnormal HDL-C showed a stronger negative association (β = -3.16, 95% CI -4.85 to -1.47) than those with normal HDL-C (normal vs. abnormal, P for interaction = 0.004). We observed that increased CIMT was significantly associated with cognitive impairment in the hypertensive population, especially among individuals with an age greater than 60 years and HDL-C deficiency. Overall, upon diagnosis of hypertension, treatment should start at the earliest opportunity to prevent end-organ damage and cognitive decline.
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Tuo J, He W, Yang S, Liu L, Liu X, Liu H, Wang Y, Tang T, Xia J, Liao W, Liu Y, Huang Q. Disrupted Topological Organization of Functional Networks in Asymptomatic Carotid Plaque Without Significant Carotid Stenosis: A Resting-State fMRI Study. Front Hum Neurosci 2021; 15:685763. [PMID: 34421560 PMCID: PMC8375554 DOI: 10.3389/fnhum.2021.685763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: Previous studies have found that there are significant changes in functional network properties for patients with moderate to severe carotid artery stenosis. Our study aimed to explore the topology properties of brain functional network in asymptomatic patients with carotid plaque without significant stenosis. Methods: A total of 61 asymptomatic patients with carotid plaque (mean age 61.79 ± 7.35 years) and 25 healthy control subjects (HC; 58.12 ± 6.79 years) were recruited. General data collection, carotid ultrasound examination and resting state functional magnetic resonance imaging were performed on all subjects. Graph-theory was applied to examine the differences in the brain functional network topological properties between two groups. Results: In the plaque group, Eloc(P = 0.03), γ (P = 0.01), and σ (P = 0.01) were significantly higher than in the HC group. The degree centrality of left middle frontal gyrus and the nodal efficiency of left middle frontal gyrus and right inferior parietal angular gyrus were significantly higher in the plaque group than in HC. The degree centrality and betweenness centrality of right middle temporal gyrus, as well as the nodal efficiency of right middle temporal gyrus, were significantly lower in the plaque group than in HC. Conclusions: The brain functional networks of patients with carotid plaques differ from those of healthy controls. Asymptomatic patients with carotid plaques exhibit increased local and global connectivity, which may reflect subtle reorganizations in response to early brain damage.
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Affiliation(s)
- Jia Tuo
- Department of Neurology, Chenzhou No.1 People's Hospital, Chenzhou, China.,Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wei He
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Shuai Yang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lihui Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojuan Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Liu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Wang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Tang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Xia
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Weihua Liao
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Yunhai Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qing Huang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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10
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Ihle-Hansen H, Ihle-Hansen H, Sandset EC, Hagberg G. Subclinical Carotid Artery Atherosclerosis and Cognitive Function: A Mini-Review. Front Neurol 2021; 12:705043. [PMID: 34393982 PMCID: PMC8355501 DOI: 10.3389/fneur.2021.705043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
Carotid artery atherosclerosis, the result of a multitude of vascular risk factors, is a promising marker for use in risk stratification. Recent evidence suggests that carotid artery atherosclerosis affects cognitive function and is an independent risk factor for the development of cognitive impairment. Both atherosclerosis and cognitive impairment develop over a prolonged period (years), and due to the aging population, markers to identify persons at risk are needed. Carotid artery atherosclerosis can easily be visualized using non-invasive ultrasound, potentially enabling early and intensified risk factor management to preserve cognitive function or delay further decline. However, the burden of atherosclerosis and temporal exposure required to pose a risk of cognitive impairment is unclear. This mini-review aims to explore the available evidence on the association between carotid atherosclerosis and cognition, and furthermore identify the remaining gaps in knowledge.
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Affiliation(s)
- Håkon Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
| | | | - Guri Hagberg
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
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Valladão Júnior JBR, Suemoto CK, Goulart AC, Schmidt MI, Passos VMA, Barreto SM, Lotufo PA, Bensenor IM, Santos IS. Anemia and Cognitive Performance in the ELSA-Brasil Cohort Baseline. J Neuropsychiatry Clin Neurosci 2021; 32:227-234. [PMID: 31795805 DOI: 10.1176/appi.neuropsych.19040088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The association between cognitive performance and hemoglobin concentration has long been a topic of debate, but few data for middle-aged persons have been explored. The authors examined the association between anemia and cognitive performance at baseline assessment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of individuals from six Brazilian cities. METHODS A total of 13,624 participants (mean age=51.6 years [SD=9.0]) were included in this cross-sectional study. Cognitive performance was evaluated by using standardized scores for verbal learning, late recall, word recognition, a semantic verbal fluency test, and the Trail-Making Test, Part B (TMT-B). The association between anemia and cognitive performance was examined by using linear regression models adjusted for sociodemographic characteristics and cardiovascular risk factors. RESULTS Anemia was diagnosed in 713 (5.2%) participants. No association was found between anemia and worse cognitive performance for the main models. Global cognitive scores were similar between participants with and without anemia in adjusted models for the entire sample (β=-0.004; 95% CI=-0.052, 0.044) or for men (β=0.047; 95% CI=-0.053, 0.146) and women (β=-0.015; 95% CI=-0.070, 0.040) separately. In addition, hemoglobin levels (in quintile groups) were not associated with global cognitive scores. Similarly, no significant associations with anemia or hemoglobin levels were observed when each cognitive performance test was evaluated separately. CONCLUSIONS Anemia and hemoglobin levels were not associated with worse cognitive performance in this large cohort.
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Affiliation(s)
- José Benedito R Valladão Júnior
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Claudia K Suemoto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Alessandra C Goulart
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Maria Ines Schmidt
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Valéria M A Passos
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Sandhi M Barreto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Paulo A Lotufo
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Isabela M Bensenor
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
| | - Itamar S Santos
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (Valladão, Suemoto, Lotufo, Bensenor, Santos); Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil (Suemoto, Goulart, Lotufo, Bensenor, Santos); Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil (Schmidt); and Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Passos, Barreto)
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Iribarren C, Chandra M, Molloi S, Sanchez G, Azamian-Bidgoli F, Cho HM, Ding H, Yaffe K. Breast Arterial Calcification Is Not Associated with Mild Cognitive Impairment or Incident All-Cause Dementia Among Postmenopausal Women: The MINERVA Study. J Womens Health (Larchmt) 2020; 30:848-856. [PMID: 33290145 DOI: 10.1089/jwh.2020.8372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Since vascular risk factors are implicated in cognitive decline, and breast arterial calcification (BAC) is related to vascular risk, we postulated that BAC may be associated with cognitive impairment and dementia. Methods: We used a multiethnic cohort of 3,913 asymptomatic women 60-79 years of age recruited after mammography screening at a large health plan in 2012-2015. A BAC mass score (mg) was derived from digital mammograms. Cognitive function was measured at baseline using the Montreal Cognitive Assessment (MoCA) and incident all-cause dementia (n = 49 events; median follow-up = 5.6 years) were ascertained with validated ICD-9 and ICD-10 codes. We used cross-sectional linear regression of MoCA scores on BAC, then multinomial logistic regression predicting mild cognitive impairment not progressing to dementia and incident all-cause dementia and, finally, Cox regression of incident all-cause dementia. Results: No association by linear regression was found between MoCA scores and BAC presence in unadjusted or adjusted analysis. Women with severe (upper tertile) BAC had a MoCA score lower by 0.58 points (standard error [SE] = 0.18) relative to women with no BAC. However, this difference disappeared after multivariate adjustment. No significant associations were found in multinomial logistic regression for either BAC presence or gradation in unadjusted or adjusted analysis. No significant associations were found between BAC presence with incident all-cause dementia (fully adjusted hazard ratio = 0.74; 95% confidence interval: 0.39-1.39). Likewise, no significant association with incident all-cause dementia was noted for BAC gradation. Conclusions: Our results do not support the hypothesis that BAC presence or gradation may contribute to cognitive impairment or development of all-cause dementia.
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Affiliation(s)
- Carlos Iribarren
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Malini Chandra
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Sabee Molloi
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Gabriela Sanchez
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Fatemeh Azamian-Bidgoli
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Hyo-Min Cho
- Safety Measurement Institute, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea
| | - Huanjun Ding
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Kristine Yaffe
- Departments of Psychiatry and Neurology and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Santos IDS, Suemoto CK, ValladÃo-Junior JBR, Liu S, Barreto SM, Fedeli LMG, Lotufo PA, Bensenor IM. Serum folate levels and cognitive performance in the ELSA-Brasil baseline assessment. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:672-680. [PMID: 33263638 DOI: 10.1590/0004-282x20200074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/13/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Most studies that analyze the association between serum folate levels and cognitive function either restrict their assessments to specific clinical scenarios or do not include middle-aged individuals, to whom strategies for preventing cognitive impairment may be more feasible. OBJECTIVE To examine the association between serum folate levels and cognitive function in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. METHODS Data from 4,571 ELSA-Brasil participants who live in the state of São Paulo, aged 35-74 years, were analyzed. The word list learning, delayed recall, word recognition, verbal fluency, and Trail Making Test Part B consisted in the cognitive tests. For each test, age, sex, and education-specific standardized scores and a global cognitive score were calculated. Crude and adjusted linear regression models were used to examine the associations of serum folate levels with cognitive test scores. RESULTS In multivariable-adjusted models, serum folate was not associated with global cognitive score (β=-0.043; 95% confidence interval [95%CI] -0.135 to 0.050 for lowest vs. highest quintile group), nor with any cognitive test performance. We did not find associations between serum folate and global cognitive scores in subgroups stratified by age, sex, or use of vitamin supplements either. CONCLUSIONS We did not find significant associations between serum folate and cognitive performance in this large sample, which is characterized by a context of food fortification policies and a consequent low frequency of folate deficiency. Positive results from previous studies may not apply to the increasingly common contexts in which food fortification is implemented, or to younger individuals.
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Affiliation(s)
- Itamar de Souza Santos
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Clínica e Epidemiológica, São Paulo SP, Brazil.,Universidade de São Paulo. Faculdade de Medicina, Departamento de Clínica Médica, São Paulo SP, Brazil
| | - Claudia Kimie Suemoto
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Clínica e Epidemiológica, São Paulo SP, Brazil.,Universidade de São Paulo. Faculdade de Medicina, Departamento de Clínica Médica, São Paulo SP, Brazil
| | | | - Simin Liu
- Brown University, School of Public Health, Department of Epidemiology, Providence, RI, United States of America
| | - Sandhi Maria Barreto
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Preventiva e Social, Belo Horizonte MG, Brazil
| | - Ligia Maria Giongo Fedeli
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Clínica e Epidemiológica, São Paulo SP, Brazil
| | - Paulo Andrade Lotufo
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Clínica e Epidemiológica, São Paulo SP, Brazil.,Universidade de São Paulo. Faculdade de Medicina, Departamento de Clínica Médica, São Paulo SP, Brazil
| | - Isabela Martins Bensenor
- Universidade de São Paulo, Hospital Universitário, Centro de Pesquisa Clínica e Epidemiológica, São Paulo SP, Brazil.,Universidade de São Paulo. Faculdade de Medicina, Departamento de Clínica Médica, São Paulo SP, Brazil
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14
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Lin HF, Huang LC, Chen CK, Juo SHH, Chen CS. Carotid atherosclerosis among middle-aged individuals predicts cognition: A 10-year follow-up study. Atherosclerosis 2020; 314:27-32. [PMID: 33129083 DOI: 10.1016/j.atherosclerosis.2020.10.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS There is a lack of studies simultaneously evaluating the impact of structural and functional atherosclerosis on cognition. We investigated the long-term predictive and interaction effects of structural and functional carotid atherosclerosis markers on future cognitive decline. METHODS Five hundred and twenty-eight middle-aged participants enrolled in the carotid atherosclerosis examination in Kaohsiung Atherosclerosis Longitudinal Study (KALS) between 2006 and 2009 were tested for cognition between 2016 and 2019. The Montreal Cognitive Assessment (MoCA) was used for the cognitive test. Baseline structural atherosclerosis was assessed by carotid intima-media thickness (cIMT) and plaque, whereas functional atherosclerosis was evaluated by carotid stiffness (β, Ep, and pulse wave velocity). Participants in the top quartile of cIMT and those with plaques were considered to have advanced structural atherosclerosis, whereas participants with all three stiffness parameters in the top quartile were defined to have advanced functional atherosclerosis. RESULTS The mean participant age at baseline was 53.88 ± 8.37 years. Each case of advanced structural atherosclerosis and advanced functional atherosclerosis was associated with low 10-year MoCA scores with p < 0.001 and p = 0.03, respectively. An interaction effect was observed between structural and functional atherosclerosis on the MoCA score 10 years later (p = 0.02). Participants with both advanced structural and functional markers showed a marked impact on future cognitive function, especially executive and language domains. CONCLUSION Carotid atherosclerosis in middle-aged individuals can predict their cognitive function in 10 years. Integrated information regarding both arterial wall and stiffness could help improve the predictive power for cognitive decline.
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Affiliation(s)
- Hsiu-Fen Lin
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Chun-Kai Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Suh-Hang H Juo
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Institute of New Drug Development, China Medical University, Taichung, Taiwan.
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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15
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Liu B, Li J, Lin X, Hu J, Lou S. The metabolic changes in the hippocampus of an atherosclerotic rat model and the regulation of aerobic training. Metab Brain Dis 2020; 35:1017-1034. [PMID: 32240489 DOI: 10.1007/s11011-020-00566-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/17/2020] [Indexed: 01/17/2023]
Abstract
Atherosclerosis has been associated with the progression of cognitive impairment and the effect of metabolic changes in the brain on cognitive function may be pronounced. The aim is to reveal the metabolic changes during atherosclerosis and clarify the possible role of exercise in regulating hippocampal metabolism. Hence, A rat model of atherosclerosis was established by high-fat diet feeding in combination with vitamin D3 intraperitoneal injection, then 4 weeks of aerobic exercise was conducted. Metabolomics based on GC-MS was applied to detect small molecules metabolites and western blot was used to detect the concentration of enzymes involved in metabolic changes in rat hippocampus. Compared to the control group, metabolites including xylulose 5-phosphate, threonine, succinate, and nonanoic acid were markedly elevated, whereas methyl arachidonic acid and methyl stearate decreased in the AS group, accompanied by a raised concentration of aldose reductase and glucose 6-phosphate dehydrogenase as well as a declined concentration of acetyl-CoA carboxylase and fatty acid synthase. After 4 weeks' aerobic exercise, the levels of succinic acid, branched chain amino acids, nonanoic acid, desmosterol, and aldose reductase decreased, whereas methyl arachidonic acid, methyl stearate, and glyceraldehyde-3-phosphate elevated in the hippocampus of the TAS group in comparison with the AS group. These results suggest that atherosclerosis could cause a severe metabolic disturbance, and aerobic exercise plays an important role in regulating atherosclerosis-induced disorder of glucose metabolism in the hippocampus.
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Affiliation(s)
- Beibei Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, 200438, China
- Department of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Jingjing Li
- Post-doctoral station of clinical medicine, Tongji Hospital, medical school of Tongji University, Shanghai, 200092, China
| | - Xiaojing Lin
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, 200438, China
| | - Jingyun Hu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, 200438, China
| | - Shujie Lou
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, 200438, China.
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Del Brutto OH, Mera RM, Recalde BY, Del Brutto VJ. Carotid Intima-media Thickness, Cognitive Performance and Cognitive Decline in Stroke-free Middle-aged and Older Adults. The Atahualpa Project. J Stroke Cerebrovasc Dis 2020; 29:104576. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.104576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/24/2019] [Indexed: 12/16/2022] Open
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Wei W, Yi X, Ruan J, Duan X, Luo H, Lv Z. Influence of collateral circulation on cerebral blood flow and frontal lobe cognitive function in patients with severe internal carotid artery stenosis. BMC Neurol 2019; 19:151. [PMID: 31277587 PMCID: PMC6612158 DOI: 10.1186/s12883-019-1380-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 06/26/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND This study aimed to investigate the cerebral blood flow (CBF) and frontal lobe cognitive function in severe internal carotid artery (ICA) stenosis patients with different types of collateral circulation. METHODS One hundred twenty-six patients with severe unilateral ICA stenosis were enrolled. Digital subtraction angiography (DSA) was performed to recruit patients with one of three common types of collateral circulation: anterior communicating artery (AcoA), posterior communicating artery (PcoA) and ophthalmic artery (OA). The hemodynamic parameters of the middle cerebral artery (MCA) were measured using transcranial Doppler (TCD), and the individual frontal lobe cognitive attention functions were evaluated using Word Fluency Test, Trail-Making Test (TMT), Digit Span, and Stroop Color Word Test (SCWT). The correlation between hemodynamic changes and the scores of all tasks was analyzed. RESULTS On the side of arterial stenosis, the CBF velocities were highest in AcoA group and lowest in the OA group. All patients performed worse in TMT and Digit Span than the matched normal controls. The AcoA group exhibited a lower pulsatility index (PI) and a longer response time in the Stroop task, but had a higher accuracy rate in the Stroop task and higher scores in Word Fluency Test than the PcoA and OA groups. In all the three groups, PI was positively correlated with the accuracy rate for Stroop interference effects. CONCLUSIONS Our findings suggested that the frontal lobe cognitive function of patients with ICA was impaired, and AcoA collaterals may be beneficial for selective attention functions, whereas OA collaterals may be associated with impairment of selective attention functions. Additionally, a high PI may be an indicator for identifying impaired selective attention in patients with severe ICA stenosis.
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Affiliation(s)
- Wei Wei
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Road, Luzhou, 646000 Sichuan China
| | - Xingyang Yi
- Department of Neurology, People’s Hospital of Deyang City, Deyang, 618000 Sichuan China
| | - Jianghai Ruan
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Road, Luzhou, 646000 Sichuan China
| | - Xiaodong Duan
- Department of Rehabilitation medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, 646000 Sichuan China
| | - Hua Luo
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Road, Luzhou, 646000 Sichuan China
| | - Zhiyu Lv
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Road, Luzhou, 646000 Sichuan China
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Utility of combined inflammatory biomarkers for the identification of cognitive dysfunction in non-diabetic participants of the ELSA-Brasil. Psychoneuroendocrinology 2019; 103:61-66. [PMID: 30641436 DOI: 10.1016/j.psyneuen.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/23/2018] [Accepted: 01/03/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Insulin resistance and low-grade inflammation are pathophysiological mechanisms shared by type 2 diabetes and dementia. A cluster of biomarkers that could help diagnosing cognitive dysfunction prior to the installation of insulin resistance is desirable. This ELSA sub-study examined whether a cluster of selected inflammatory biomarkers was associated with worse cognitive scores in non-diabetic participants. METHODS A sample of 998 non-diabetic participants of ELSA-Brasil had their cognitive function assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), a verbal fluency test and a trail making test. An inflammatory cluster was formed by using the k-means method. ANOVA was used to compare the tertiles of a composite global cognitive z-score with clinical and laboratory variables. Logistic regression modelling with forward stepwise model selection was performed considering cognitive performance as the outcome and the cluster as the independent variable of main interest. Models were stratified by sex and adjusted for age, insulin resistance and other confounders. RESULTS The mean age was 45.7 ± 4.9 years and 54.8% were women, who had a higher frequency of university level, healthier behaviors and lower systolic and diastolic blood pressure (BP) levels, fasting plasma glucose, non-HDL cholesterol and E-selectin levels than men. Individuals in the highest tertile of the composite global cognitive z-score were more likely to be women, with university level, and lower mean values of body mass index, BP levels, and HOMA-IR than those in lower tertiles. Using logistic regression model, the cluster category of the highest grade of inflammation showed to be associated with worse cognitive performance in women only. CONCLUSION The association between a cluster of inflammation and worse cognitive performance seems to be useful to identify middle-aged women at risk for cognitive decline, independently of their state of insulin resistance.
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Tuo J, Liu Y, Liao W, Gu W, Yang S, Tan X, Tang T, Chen H, Feng J, Wen Y, He W, Huang Q. Altered brain volume and its relationship to characteristics of carotid plaques in asymptomatic patients. Medicine (Baltimore) 2018; 97:e13821. [PMID: 30593177 PMCID: PMC6314752 DOI: 10.1097/md.0000000000013821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/24/2018] [Accepted: 12/03/2018] [Indexed: 12/27/2022] Open
Abstract
Carotid plaque is an aggregate marker of exposure to vascular risk factors, which are linked to structural brain changes. We investigated prestroke global and regional changes in brain volume in a carotid plaque population of cognitively healthy individuals and the association between carotid plaque characteristics and these changes.A total of 76 participants were divided into healthy control (HC, n = 28), vulnerable plaque (n = 27) and stable plaque groups (n = 21). All subjects underwent carotid ultrasound and brain magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) was used to examine differences in regional gray matter volumes (rGMVs) among the different groups.The plaque group had a significantly lower mean total cerebral brain volume (TCBV) than the HC group (P = .03). Carotid intima-media thickness (CIMT) was negatively correlated with TCBV (r = -0.311, P = .006) and rGMV in the right thalamus (r = -0.589, P = .001). The rGMVs of the right middle occipital gyrus and bilateral lingual gyrus were significantly different between the unstable and stable groups. The gray-scale median (GSM) of the plaque and the total plaque risk score (TPRS) were correlated with the volume of the right middle occipital gyrus (r=-0.478, P = .001; r = 0.541, P = .001) and bilateral lingual gyrus (r = -0.419, P = .003; r = 0.288, P = .04).Carotid plaque is related to the volume of the brain parenchyma and right thalamus. The rGMVs of the right middle occipital gyrus and bilateral lingual gyrus differed between the vulnerable plaque and stable plaque groups, and the characteristics of carotid plaques may serve as indexes that reflect these changes.
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Affiliation(s)
- Jia Tuo
- Department of Neurology, Xiangya Hospital, Central South University
| | - Yunhai Liu
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Weihua Liao
- Department of Radiology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Wenping Gu
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Shuai Yang
- Department of Radiology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Xinglin Tan
- Department of Neurology, Nanhai Hospital, Southern Medical University, Foshan, Guangdong
| | - Tao Tang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
- Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China
| | - Hua Chen
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Jie Feng
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Yanbin Wen
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
| | - Wei He
- Department of Neurology, Xiangya Hospital, Central South University
| | - Qing Huang
- Department of Neurology, Xiangya Hospital, Central South University
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Changsha
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20
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Santos EHS, dos Santos PJ, Santos IDS. Carotid intima-media thickness in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a narrative review. SAO PAULO MED J 2018; 136:64-72. [PMID: 29590246 PMCID: PMC9924175 DOI: 10.1590/1516-3180.2017.0272141017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/14/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Carotid intima-media thickness (CIMT), as measured by ultrasound, has been used in large studies as a non-invasive marker for subclinical atherosclerosis. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a cohort of 15,105 civil servants in six Brazilian cities that included CIMT evaluation in its baseline assessment. The aim of the present narrative review was to provide an overview of ELSA-Brasil CIMT articles published up to July 31, 2017. DESIGN AND SETTING Narrative review of ELSA-Brasil CIMT studies using baseline assessment data. METHODS We searched PubMed for the terms "ELSA-Brasil" and "intima-media". This search yielded 21 published articles using CIMT data from the ELSA-Brasil baseline assessment, which were included in this review. We also present information about intima-media thickness assessment from ongoing onsite reevaluations of the study participants. RESULTS Most published studies focused on the association with traditional and novel cardiovascular risk factors. Studies also presented information about the ELSA-Brasil CIMT protocol at baseline and CIMT value distribution in this large sample. CONCLUSIONS Analyses on the ELSA-Brasil data led to important insights on CIMT interpretation and physiology. Besides the highlighted contributions which have already been made in this field, new data gathered during the ongoing third onsite assessment will enable investigation of substantially new research questions.
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Affiliation(s)
- Eduardo Henrique Sena Santos
- MD. Physician, Imaging Service, and Researcher, Center for Clinical and Epidemiological Research, Hospital Universitário (HU), Universidade de São Paulo (USP), São Paulo (SP), Brazil.
| | - Pedro José dos Santos
- MD. Physician, Imaging Service, and Researcher, Center for Clinical and Epidemiological Research, Hospital Universitário (HU), Universidade de São Paulo (USP), São Paulo (SP), Brazil.
| | - Itamar de Souza Santos
- MD, PhD. Researcher, Center for Clinical and Epidemiological Research, Hospital Universitário (HU), Universidade de São Paulo (USP), and Associate Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
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21
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Cezaretto A, Suemoto CK, Bensenor I, Lotufo PA, de Almeida-Pititto B, Ferreira SRG. Association of adiponectin with cognitive function precedes overt diabetes in the Brazilian Longitudinal Study of Adult Health: ELSA. Diabetol Metab Syndr 2018; 10:54. [PMID: 30002734 PMCID: PMC6038247 DOI: 10.1186/s13098-018-0354-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/28/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Adiponectin is an insulin-sensitizer adipocytokine endowed with neuroprotective actions. Whether adiponectin regulates neuronal functioning toward delaying cognitive decline independently of the glucose metabolism disturbance has been poorly explored. This study evaluated if the performance in cognitive tests was associated with adiponectin levels prior the development of type 2 diabetes in middle-aged individuals. METHODS A sample of 938 non-diabetic participants of ELSA had their cognitive function assessed by the CERAD delayed word recall test, the verbal fluency test and the trail making test. Stepwise multiple linear regression using forward selection had the response to cognitive tests as the dependent variable and adiponectin as the independent variable of main interest, adjusted for glucose tolerance status and confounders. RESULTS Mean age was 45.7 ± 4.9 years, 54.5% were women, 43.0% had high education level, 59.3% weight excess and 70.0% prediabetes. In crude model, only the delayed recall memory was associated with adiponectin levels. In an initial regression model, delayed recall memory remained independently associated with adiponectin levels and prediabetes. After complete adjustments, adiponectin but not prediabetes maintained independently associated with delayed recall memory (β 0.067; 95% CI 0.006-0.234; p = 0.040). On the other hand, learning memory showed to be associated with prediabetes (β 0.71 95% CI 0.17; 1.24; p = 0.009) but not with adiponectin. CONCLUSIONS The association of memory with adiponectin in middle-aged individuals, prior overt diabetes, suggests that this adipocytokine could anticipate cognitive impairmentρ detection, when preventive strategies could be more effectively implemented. The usefulness of adiponectin to identify increased risk for cognitive dysfunction before advanced age needs to be prospectively investigated in ELSA cohort.
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Affiliation(s)
- Adriana Cezaretto
- Department of Epidemiology, School of Public Health, University of Sao Paulo, São Paulo, Brazil
| | | | - Isabela Bensenor
- Department of Internal Medicine, Medical School, University of Sao Paulo, São Paulo, Brazil
| | - Paulo A. Lotufo
- Department of Internal Medicine, Medical School, University of Sao Paulo, São Paulo, Brazil
| | | | - Sandra R. G. Ferreira
- Department of Epidemiology, School of Public Health, University of Sao Paulo, São Paulo, Brazil
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22
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Suemoto CK, Bittencourt MS, Santos IS, Benseñor IM, Lotufo PA. Coronary artery calcification and cognitive function: cross-sectional results from the ELSA-Brasil study. Int J Geriatr Psychiatry 2017; 32:e188-e194. [PMID: 28240378 DOI: 10.1002/gps.4698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/03/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We examined the relationship between coronary artery calcification (CAC) score and performance in cognitive tests in a large Brazilian sample. METHODS In this cross-sectional study, 4104 participants (mean age = 50.9 ± 8.8 years old, 54% female) from the Brazilian Longitudinal Study of Adult Health had complete information for CAC and cognitive tests. We used linear regression models adjusted for sociodemographics, cardiovascular risk factors (hypertension, diabetes, smoking, alcohol use, physical activity, and body mass index), depression, and thyroid function. To investigate potential different associations for middle-aged and older adults, we stratified the analysis by age groups. RESULTS Participants with CAC ≥ 100 Agatston score had poorer performance in the trail making test compared to those with CAC < 100 Agatston score (β = -0.101, 95% CI = -0.194; -0.010, p = 0.03). We did not find any other association between CAC and cognitive tests. When we investigated the effect modification between CAC and age on cognitive tests, only the effect modification on global cognition (p = 0.02) and trail making test was significant (p = 0.0003). CONCLUSIONS Higher CAC was weakly associated with poorer performance in an executive function test in a large sample from the Brazilian Longitudinal Study of Adult Health. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Claudia K Suemoto
- Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Marcio S Bittencourt
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
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23
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Gardener H, Caunca MR, Dong C, Cheung YK, Elkind MSV, Sacco RL, Rundek T, Wright CB. Ultrasound Markers of Carotid Atherosclerosis and Cognition: The Northern Manhattan Study. Stroke 2017; 48:1855-1861. [PMID: 28630235 PMCID: PMC5482565 DOI: 10.1161/strokeaha.117.016921] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/04/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Ultrasound markers of carotid atherosclerosis may be related to cognitive status. We hypothesized that individuals with greater carotid intima-media thickness (cIMT) and carotid plaque burden would exhibit worse cognition. METHODS One thousand one hundred sixty-six stroke-free participants from the NOMAS (Northern Manhattan Study) underwent carotid ultrasound and neuropsychological examination. Among them, 826 underwent a second neuropsychological examination an average of 5 years later. cIMT and plaque were assessed by a standardized B-mode ultrasound imaging and reading protocol. We used multivariable linear regression to examine cIMT, carotid plaque presence, and carotid plaque area as correlates of domain-specific neuropsychological Z scores cross-sectionally and over time. We also investigated possible effect modification by APOE ε4 allele, age, and race/ethnicity. RESULTS Participants had a mean (SD) age of 70 (9) years and were 60% women, 66% Hispanic, 15% white, and 18% black. Those with greater cIMT exhibited worse episodic memory after adjustment for demographics and vascular risk factors (β=-0.60; P=0.04). APOE ε4 carriers with greater cIMT exhibited worse episodic memory (β=-1.31; P=0.04), semantic memory (β=-1.45; P=0.01), and processing speed (β=-1.21; P=0.03). Participants with greater cIMT at baseline did not exhibit significantly greater cognitive decline after adjustment. APOE ε4noncarriers with greater cIMT exhibited greater declines in executive function (β=-0.98; P=0.06). Carotid plaque burden was not significantly associated with cognition at baseline or over time. CONCLUSIONS Subclinical carotid atherosclerosis was associated with worse cognition among those at higher risk for Alzheimer disease. Interventions targeting early stages of atherosclerosis may modify cognitive aging.
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Affiliation(s)
- Hannah Gardener
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.).
| | - Michelle R Caunca
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Chuanhui Dong
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Ying Kuen Cheung
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Mitchell S V Elkind
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Ralph L Sacco
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Tatjana Rundek
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Clinton B Wright
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
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Li X, Lyu P, Ren Y, An J, Dong Y. Arterial stiffness and cognitive impairment. J Neurol Sci 2017; 380:1-10. [PMID: 28870545 DOI: 10.1016/j.jns.2017.06.018] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/10/2017] [Accepted: 06/13/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. OBJECTIVES AND METHODS To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. RESULTS We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility damages the cerebral microcirculation, which causes various phenomena associated with cerebral small vessel diseases (CSVDs), such as white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), and lacunar infarctions (LIs). The mechanisms underlying the relationship between arterial stiffness and cognitive impairment may also be associated with reductions in white matter and gray matter integrity, medial temporal lobe atrophy and Aβ protein deposition. Engaging in more frequent physical exercise; increasing flavonoid and long-chain n-3 polyunsaturated fatty acid consumption; increasing tea, nitrite, dietary calcium and vitamin D intake; losing weight and taking medications intended to improve insulin sensitivity; quitting smoking; and using antihypertensive drugs and statins are early interventions and lifestyle changes that may be effective in preventing arterial stiffness and thus preventing cognitive impairment. CONCLUSION Arterial stiffness is a sensitive predictor of cognitive impairment, and arterial stiffness severity has the potential to serve as an indicator used to facilitate treatments designed to prevent or delay the onset and progression of dementia in elderly individuals. Early treatment of arterial stiffness is beneficial and recommended.
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Affiliation(s)
- Xiaoxuan Li
- Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China; Graduate School, HeBei Medical University, Shijiazhuang 050017, China
| | - Peiyuan Lyu
- Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China; Graduate School, HeBei Medical University, Shijiazhuang 050017, China.
| | - Yanyan Ren
- Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China; Graduate School, HeBei Medical University, Shijiazhuang 050017, China
| | - Jin An
- Hebei North University, Zhangjiakou 075000, China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China
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Lotufo PA. New findings about atherosclerosis in Brazil from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). SAO PAULO MED J 2016; 134:185-6. [PMID: 27355798 PMCID: PMC10496602 DOI: 10.1590/1516-3180.2016.1344090516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Paulo Andrade Lotufo
- MD, DrPH. Full Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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